Rachel Bonnifield
@rachelbonnifield.bsky.social
500 followers 520 following 95 posts
Director of Global Health Policy & Senior Fellow @Cgdev. Global health, lead poisoning, R&D, AMR, pandemic prep, pharma, econ, and development, with a side of foster kittens. Views are my own.
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Reposted by Rachel Bonnifield
orinlevine.bsky.social
How do you find $2.5 B in savings when every decision has consequences for access to life-saving vaccines? With Center for Global Development colleagues, here are 2 core principles and 5 suggestions. Give it a read and let us know what you think. #gavi
Reposted by Rachel Bonnifield
jmadankeller.bsky.social
Cutting US funding for @gavi.org which leads on global vaccination efforts is incredibly shortsighted and misguided

@charlesjkenny.bsky.social & I argued why in this @cgdev.org blog 👇

www.cgdev.org/blog/why-tru...
rachelbonnifield.bsky.social
Usual caveats, obviously not all pro Palestinian people are anti Semitic, there’s lots of people outraged for very good reasons, right wing equally bad or worse, etc.

But you’re delusional if you think there’s no meaningful anti semitism or safety risk in lefty spaces.
rachelbonnifield.bsky.social
And I am firmly in the “anti-Israel is not the same as anti-Semitism” camp, for the record.

But also not cool with setting Jewish grandmothers on fire for wrongthink, or people telling me why they think actually that’s great. (Which yes, does happen.)
rachelbonnifield.bsky.social
Yeah you’re very, very wrong on this one.

You are aware that there have been two separate terrorist attacks on American Jews* from pro-Palestinian individuals in the past two weeks? So we’re not talking just some overheated college rhetoric.

And plenty on the far left cheering or justifying them
Reposted by Rachel Bonnifield
leecrawfurd.bsky.social
Fantastic news that Switzerland have now submitted the paperwork triggering the start of the process that could eventually lead to better regulation on lead paint exports

ipen.org/news/lead-ch...
Reposted by Rachel Bonnifield
leecrawfurd.bsky.social
Starting now! Tune in on CGD YouTube
Reposted by Rachel Bonnifield
chadstanton.blacksky.app
"In Cleveland, where 20% of children have elevated lead levels, Dave Margolius, director of the Cleveland Department of Public Health say they’ve also lost CDC assistance for lead prevention.

“The percentage of children poisoned by lead in Cleveland is higher than Flint, Michigan was at its peak”"
White House to Cities: Good Luck Fighting Lead Poisoning
Centers for Disease Control staff cuts leave cities to fight lead poisoning that endangers children without federal help.
wordinblack.com
rachelbonnifield.bsky.social
We *can* negotiate and get a lower price, albeit trading off against some future innovation.

But insisting we pay the lowest price available to others will just lead pharma to raise prices elsewhere.

And that will mean we pay the same price, others get no medicine, and pharma loses money.
rachelbonnifield.bsky.social
The key point is that other countries don’t receive a “discount” against the “real” US price.

There is no “real” or “fair market” price in monopoly.

Pharma is already profit-maximizing in every market—but other countries are willing to pay less and will walk away at the US price.
rachelbonnifield.bsky.social
And if we lower prices, it will just lead to overall lower pharma profits (ok) and lower private R&D spending (debatable). There is no world where other countries pay more to make up their "share" of current R&D support -- because they do not value it as much as we do.

/end
rachelbonnifield.bsky.social
Yes, we should absolutely regulate pharma prices. But there is no version of the world where other countries paying more leads to us paying less. That's not how any of this works.

What we do has nothing to do with other countries.
rachelbonnifield.bsky.social
And in monopolist pricing, there is no “fair market price” to discount--there is just a price agreed between the seller and any given buyer. And there is no version of market capitalism that forces buyers to buy something for more than they are willing to pay."
rachelbonnifield.bsky.social
But there is no subsidizing, and there is no “overcharge” in monopoly pricing.

If you can (perfectly) price discriminate, there is just what each market is willing to bear.

Because in monopoly pricing the monopolist keeps the the economic surplus from perfect price discrimination!
rachelbonnifield.bsky.social
It is true that this price discrimination allows them to access foreign markets.

If they needed to set a single global monopolist price, it would be higher than many countries would be willing to pay – and therefore they would not have any market access or profit in those markets.
rachelbonnifield.bsky.social
Pharma companies do not “discount” their prices in foreign countries.

They are monopolists.

In every country they set a profit-maximizing monopolist price.

Because other countries have lower willingness to pay, the monopolist profit-maximizing price is lower.
rachelbonnifield.bsky.social
But here's where things go off the rails.

The EO asserts "a purposeful scheme in which drug manufacturers deeply discount their products to access foreign markets, & subsidize that decrease through enormously high prices in the United States."

That is a fundamental economic misunderstanding.
rachelbonnifield.bsky.social
Third, pharma companies do price discriminate between countries. The ability to price discriminate allows them to charge lower prices to some countries, and higher prices to the US. And effectively, the ability to price discriminate also does allow them to enter and profit from foreign markets.
rachelbonnifield.bsky.social
Second, pharma companies very much do benefit from American upstream subsidy of publicly funded R&D, and downstream public funding of medicines. And they do fight any efforts to regulate drug prices. The overall behavior is outrageous, and the government should intervene to address it.